Health care managers often blame nurses for these errors, avoiding the work of improving systems badly in need of it. Sadly, many staff nurses buy into this blame game. Try this quick exercise: look at Ian’s 12 error factors from the link above, and consider which ones affect you at work. Which ones routinely affect you? Which ones has anyone done anything about? Which ones are intentionally imposed on staff to save money?

Obvious contributors to errors, ignored or instituted by management, amounts in my mind to planned patient harm: not staff errors as much as irresponsible management. Airlines overwhelmingly focus on systems approaches; health care overwhelmingly blames people instead. Is it any surprise at all that air travel is extremely safe, and health care a leading cause of death? Health care errors kill more Americans in a day than airlines do in a decade. The abusive health care ‘blame and train/fire’ model must end, and we must demand genuine systems reform, not more public relations fiction. Thousands of lives are at stake.